The New Psychiatry: The Essential Guide to State-of-the-Art Therapy, Medication, and Emotional Health is an excellent book for educating a consumer and others. Books describing mental health care for the general public and psychiatric patients are increasingly common, but this one stands out. Dr. Gormanís objective is to get psychiatric knowledge to patients and family members and to help them get good medical care, procure well-defined goals of treatment, and determine whether these goals are being reasonably met. To paraphrase an old slogan, "An educated consumer is a psychiatristís best patient."

Gormanís basic thesis is what he calls the "New Psychiatry." His phrase captures the rich evolution of psychiatry over the last 50 years in medications, psychiatric theory and care, and in the greater precision of diagnosis. He maintains this new and needed image of psychiatry and its practitioners is predicated upon several concepts; among them: reasonable attempts should be made by psychiatrists to study all treatments scientifically and patients must be informed about the degree this has been done; patients have the obligation to insist upon a good basis for consuming prescribed medication; psychiatric care can help many people but not all; and psychiatrists must provide individualized care in an empathetic and respectful manner. This is refreshing to hear from a practicing member of the profession.

Gorman divides his text into four principal sections: Considering Treatments, The Treatments, The Illnesses, and Special Topics. Each section is subdivided into various issues, and all is presented in an informal style--as if the author were discussing the subject with a patient or one of his or her family.

Chapter 4, "Medication," is especially illuminating for the laity. Dr. Gorman briefly explains at the cellular/subcellular level the modus operandi of the various classes of psychiatric drugs--from antidepressants to the antipsychotic--and the basis for untoward effects which commonly supervene. Chapter 12, on schizophrenia, contains thorough information; its descriptions of positive and negative symptoms are carefully drawn.

While Dr. Gorman provides a wealth of information, there a few points that readers may differ with. Contrary to his comments on p. 323, stimulants like dextroamphetamines do not appreciably speed up all biological processes to thereby increase metabolism and cause weight loss. This specific drug and the amphetamines as a class act as weight-loss agents by a central elative action and by depression of the hypothalamic appetite center ("appestat"). Further, a physical withdrawal syndrome does occur when amphetamine-like stimulants are withdrawn from addicted patients. Still further (p. 324), the reader may be left with the impression that in treating attention deficit disorder (ADD), methylphenidate (Ritalinģ) acts as a cerebral stimulant; but it does not. A third point pertains to Dr. Gormanís comments on marijuana. While he specifically offers no endorsement of the drug, his comment that marijuana "is a minor problem compared to alcohol or cocaine" may allow a person prone to substance abuse to too easily rationalize the use of marijuana.

The quality of the information in Gormanís work far outweighs these few points. This well-written book is formulated by an expert, and its prose runs smoothly. The author completes the book with lists of mental health associations; suggestions for further reading; a list of the tables displayed; a list of psychiatric drugs by generic and trademark (brand) names; and a thorough index.

This is a refreshing, instructive book that brings a wealth of complex information together in one place in a most understandable manner. It is highly recommended to consumers, their loved ones, and the paramedical and social workers who labor daily in the brain-disorder trenches.

The New Psychiatry: The Essential Guide to State-of-the-Art Therapy, Medication, and Emotional Health, by Jack M. Gorman, M.D. St. Martinís Press, New York, 1996. 410 pages.

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